Introduction: 
Interstate data shows that 85% of patients accessing Voluntary Assisted Dying (VAD) are receiving palliative care. Palliative care providers may be involved in their patient’s VAD journey, including facilitating access to VAD substances by engaging pharmacy for efficient service delivery. Due to the vast geographical spread of palliative care patients across Queensland, the VAD pharmacy service model was developed to optimise service efficiency across urban and rural/remote areas. This study outlines the VAD pharmacy service model developed to suit Queensland geographical challenges.  

Aim: 
To outline the VAD Pharmacy service model implemented in Queensland.  

Methods:
The Queensland VAD service implementation team explored assisted dying pharmacy models of care published internationally. A literature review yielded studies exploring pharmacists’ and other health professionals’ perspectives on the challenges and benefits of centralised and decentralised pharmacy models. 

Additionally, the team evaluated skills required for pharmacists to deliver good quality palliative and end-of-life care to patients accessing VAD. 

Results:
Based on the findings, a centralised VAD pharmacy service model was adopted to create time and cost efficiency, and a central point of contact for all referrers including palliative care providers. 

To enable VAD pharmacists to be highly skilled in supporting patients at end of life, the pharmacy stream lead was recruited from the palliative care sector and all employed pharmacists are provided with extensive palliative care training. This includes: 

1.       Over 76 hours of palliative-care related orientation training

2.       Continuous palliative care-related pharmacy education such as
-          Journal clubs

-          Professional developments

-          Structured debriefing sessions

-          Supervision 

-          Multidisciplinary case conferences 

 

Discussion:
A centralised pharmacy service supports a cost-effective and time efficient service model that has the advantage of trained specialist palliative care pharmacists employed to provide streamlined and responsive support to referring services including palliative care providers and their patients.